TRANSFER OF A BRANCH OF THE ANTERIOR INTEROSSEOUS NERVE TO THE MOTOR BRANCH OF THE MEDIAN NERVE AND ULNAR NERVE

Objective To explore the applied microsurgical anatomy of the intrinsi c hand muscles and related nerves after nerve injuries in the wrist re gion and to report the results of new technique for the restoration of motor functions oi the injured nerves. Methods Seven fresh forearm am putation specimens were employed for studying the anatomical and micro surgical characteristics of the relevant tissues. Transfer of the pron ator quadratus branch of the anterior interosseous nerve (PBAN) to the recurrent branch of the median nerve (RBMN) and the deep branch of th e ulnar nerve (DBUN) to restore the functions of the intrinsic hand mu scles was performed on 20 patients from April 1979 to January 1994. Fo urteen patients were followed up for 3-9 years with an average of 5 ye ars and 8 months. Results The RBMN, DBUN and PBAN had approximately th e same lengths of diameter and similar amounts of fascicles and nerve fibers so that after nerve transfer, the possibilities of misdirected connections were greatly reduced. In the latest follow-up, normal musc le strength was regained in 3 patients, grade VI strength in 6, grade III strength in 3 and grade II strength in 2. Conclusion This new tech nique is able to restore the intrinsic hand muscular functions after m edian or ulnar nerve injuries in the wrist region or distal forearm.